Sensitization to salmon among occupationally exposed Norwegian salmon processing workers: identification of IgE-reactive proteins

Introduction: Salmon processing workers are exposed to bioaerosols and are at risk of developing respiratory diseases and other hypersensitivity reactions. The aim of this study was to investigate the prevalence of allergic sensitization to salmon in a study population of Norwegian salmon processing workers and to investigate salmon proteins involved in IgE-binding. Method: ). They were also invited to answer a general questionnaire, including questions on asthma, work-related symptoms, and food-allergy to salmon. Serum from 71 sensitized workers with either a positive SPT and/or elevated sIgE to salmon, were further analyzed by immunoblot, with in-house and commercial protein extracts. Salmon proteins which were most frequently involved in IgE-binding were identified using mass spectrometric analyses of SDS-PAGE protein bands. Results: = 71) in the present study population. Fifty-six workers had at least one positive SPT, with most having a reaction to the in-house raw muscle extract (61%), followed by in-house mucus (42%), in-house cooked muscle (17%), commercial cod (11%), commercial salmon (8%), and in-house skin (3%). All sensitized workers had IgE-binding to proteins in at least one of the protein extracts, with immunoblot protocols: mucus (100%), raw muscle (79%), cooked muscle (20%), skin (6%), and commercial cod (24%). Most frequent IgE-binding was seen in the 60-70 and >131 kDa area for mucus, and 60-70 kDa for raw muscle. Work-related symptoms were reported by 43 workers. Only three workers had self-reported allergy to salmon related to food intake, whereas 10 workers had self-reported doctor-diagnosed asthma. With mass spectrometry, known allergens were identified, as well as potentially novel allergens with possible clinical relevance. Conclusion: Norwegian salmon processing workers are exposed to various salmon tissues at work, containing proteins which might cause allergic sensitization. Allergens other than the major fish allergen parvalbumin, including allergens not previously identified as salmon allergens, seem to play an important role in the occupational setting.